In the PLATO trial “comparing ticagrelor with clopidogrel (on a background of aspirin therapy) . . . for the prevention of vascular events and death in . . . ACS” . . . “patients enrolled in North America” showed “_________ differences between ticagrelor and clopidogrel with respect to the primary efficacy endpoint ”One possible explanation was that “a significantly higher proportion of patients in the United States received a median aspirin dose of _______ compared with the rest of the world . . . ”

“The writing group cautions that data on the use of prasugrel and ticagrelor come solely from the TRITON–TIMI 38 and PLATO trials, respectively, . . . ________ was administered only after a decision to proceed to ______ was made, whereas ________ was studied in “all-comer” patients with UA/NSTEMI, including invasively and medically managed patients. ”

“Patients with definite UA/NSTEMI at medium or high risk and in whom an initial invasive strategy is selected . . . Aspirin should be initiated on presentation . . .The choice of a second antiplatelet therapy to be added to aspirin on presentation includes . . .Before PCI: ____________________ ” (in contrast to “At the time of PCI”)

“Patients with definite UA/NSTEMI at medium or high risk and in whom an initial invasive strategy is selected . . . Aspirin should be initiated on presentation . . .The choice of a second antiplatelet therapy to be added to aspirin on presentation includes . . .At the time of PCI: ____________________ ”

Aug 31, 2012According to the 2012 ACCF/AHA Focused Update of the Guideline for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction(PDF) (p 657)the following is a “Class I” recommendation:“A loading dose of P2Y12 receptor inhibitor therapy is recommended for UA/NSTEMI patients for whom PCI is planned.‡ One of the following regimens should be used:a. Clopidogrel ____ should be given as early as possible before or at the time of PCI . . . or b. Prasugrel* ____ should be given promptly and no later than 1 hour after PCI once . . . decision . . . to proceed with PCI . . . or c. Ticagrelor† ____ should be given as early as possible before or at the time of PCI . . . ”

“Recommendation 5: The organizations recommend __ __ __ __ __ for initial diagnosis in patients with an intermediate pretest probability of IHD who have an interpretable ECG and at least moderate physical functioning or no disabling comorbidity”

Nov 28, 2012According to the 2012 ACP/ACC/AHA Diagnosis of Stable Ischemic Heart Disease Summary (p 731, Recommendation 14)“ . . . to Assess Risk in Patients With Known Stable IHD Who Are Able to Exercise”“The organizations recommend __ __ __ __ __ __ testing for risk assessment in patients who are able to exercise to an adequate workload and have an ECG that can be interpreted during exercise”

Nov 29, 2012According to the 2012 ACP/ACC/AHA Diagnosis of Stable Ischemic Heart Disease Summary (p 731, Recommendation 16)“ . . . to Assess Risk in Patients With Known Stable IHD Who Are Able to Exercise”“The organizations recommend . . . cardiac computed tomography angiography __ __ __ __ __ __ __ __ for risk assessment in patients with stable IHD who are able to exercise to an adequate workload and have an interpretable ECG”

a) is the test of choiceb) is preferred over standard exercise ECG and is an alternative to stress with radionuclide myocardial perfusion imaging or echocardiography c) is a reasonable initial testd) should not be used